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Healthwise Maui

Q: What does it mean to be prediabetic? Can I reverse it?

Jolly Anne L. Uclaray, Master of Science nursing, registered nurse, certified diabetes educator, diabetes coordinator, Maui Memorial Medical Center: According to the Centers for Disease Control and Prevention, around 84 million American adults are prediabetic, but 90 percent don’t know it. Having prediabetes means that your blood sugar level is higher than normal. That is an A1C 5.7 to 6.4 percent. The good news is, by making lifestyle changes, you can reverse it, and protect yourself from developing diabetes.

If you are overweight, over age 45, or have a close relative with type 2 diabetes, you are at higher risk. Since there are often no clear symptoms with prediabetes, you should ask your doctor for a blood sugar test or A1C.

If you are prediabetic, lifestyle changes can delay or prevent you from developing diabetes. Losing 5 to 7 percent of your body weight, 14 pounds for a 200-pound person, can lower your risk.

Physical activity, ideally 150 minutes of brisk walking every week (30 minutes a day, five days a week) can also help by lowering blood glucose levels and decreasing body fat. Eat plenty of fruits and vegetables, avoid sugary beverages, and add more fiber to your diet. Finally, make sure you are getting enough regular sleep. Being sleep deprived makes it harder to lose weight, and reduces your body’s ability to use insulin, which is important to preventing diabetes.

Most importantly, check in with your doctor regularly to monitor your progress and help you slow or reverse the development of diabetes.

Q: What can I do to keep my blood pressure under control?

Dr. Anil Punjabi, cardiologist, Ohana Heart: High blood pressure can contribute to many life-threatening conditions, like heart attack, heart failure and stroke. Often there are not obvious symptoms of high blood pressure, so you may not realize you have it. That’s why it’s important to get regular blood pressure checks from your health care provider.

If you do have high blood pressure, there are many things you can do to keep it under control. Losing extra weight is one of the most effective things you can do to bring blood pressure down. This is especially important for people who carry weight around their middle, since carrying weight around your waistline can put you at greater risk.

Other things you can do include getting regular physical exercise — about 30 minutes of exercise (that gets your heart rate up) most days of the week — and eating a diet that’s rich in whole grains, fruits and vegetables, and low in saturated fat. Look for ways to reduce your salt intake and consider eating foods like bananas that are high in potassium, since potassium can help offset the effects of sodium. Remember that anything that comes out of a box or can has a high likelihood of having high amount of salt. Limiting alcohol and caffeine can help, and if you smoke, now is the time to quit.

Finally, if lifestyle changes aren’t enough, talk with your doctor. They can talk with you about medications that can help manage your blood pressure.

* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on Thursdays. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealthsystem.org/contact.